Strict Phosphate Control Delays CAC Progression In Patients On Hemodialysis, EPISODE Trial

Key findings of the study were:

• Upon analyzing 115 patients, the researchers found no significant difference in percentage change in CAC scores between the lanthanum carbonate group and the sucroferric oxyhydroxide group.
• However, they found a percentage change in CAC scores in the strict group (median of 8.52) was significantly lower than that in the standard group (median of 21.8).
• They reported that this effect was pronounced in older (aged 65–74 years) than in younger (aged 20–64 years) participants.
• They observed a similar finding for the absolute change in CAC scores.

The authors concluded, "Further study with a larger sample size is needed, but strict phosphate control shows promise for delaying progression of CAC in patients undergoing maintenance hemodialysis."

"EPISODE is the first completed trial to address the fundamental question of whether a strategy of guideline-endorsed phosphate normalization, as executed in the strict arm of the trial, has a favorable effect on cardiovascular health," Ron Wald, MD, of St. Michael's Hospital in Toronto and Michael W. Walsh, MD, of McMaster University in Hamilton Ontario, Canada, stated in an accompanying editorial.

For further information:

https://jasn.asnjournals.org/content/32/3/723